Glenosphere with inserts for augmented fixation and related methods

ABSTRACT

An insert component includes an insert body and a cavity defined within the insert body. The insert body includes a first surface, a second surface spaced from the first surface, and a third surface. The second surface cooperates with the first surface to define at least one first channel configured to receive an engagement member. The third surface has a first and second surface end each extending from a perimeter of the first surface. A curved portion of the third surface between the first surface end and the second surface end extends into the insert body. The cavity includes a first cavity opening defined by the first surface. The cavity defines a first cavity region and a second cavity region each coextensive with a third cavity region. The first cavity region and second cavity region each have a cavity diameter greater than a diameter of a plate engagement member.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a U.S. National Stage of International ApplicationNo. PCT/US2018/040141, filed Jun. 28, 2018, which claims the benefit ofand priority to U.S. Provisional Patent Application No. 62/526,911,filed Jun. 29, 2017, each of which is hereby incorporated by referenceherein in its entirety.

TECHNICAL FIELD

The present disclosure generally relates to the field of shoulderreplacement surgery, and more specifically to apparatuses, systems, andmethods relating to shoulder replacement using a glenosphere.

BACKGROUND

Shoulder replacement surgeries (e.g., total shoulder arthroplasty (TSA)and reverse shoulder arthroplasty (RSA) are performed to repair apatient's shoulder joint, such as when joints have been damaged or losefunctionality due to disease, bone loss, or other trauma. In somesurgeries, a glenosphere acts as a connecting element between thepatient's humerus and scapula, and may be oriented at an anatomicorientation to mimic the ball-and-joint configuration and movement of anatural shoulder joint. A base plate may be positioned between theglenosphere and the scapula, and a bone graft may be used to facilitatejoining the base plate and glenosphere to the scapula. However, evenwith a bone graft, glenoid bone loss or other deterioration of theshoulder joint even after a shoulder replacement surgery may causeadditional problems, reducing the effectiveness of the shoulderreplacement surgery.

SUMMARY

According to an aspect of the present disclosure, an insert componentfor shoulder arthroplasty includes an insert body and a cavity. Theinsert body includes a first surface, a second surface, and a thirdsurface. The first surface is configured to engage a bone. The secondsurface is spaced from the first surface and cooperates with the firstsurface to define at least one first channel configured to receive anengagement member. The third surface has a first surface end and secondsurface end each extending from a perimeter of the first surface. Acurved portion of the third surface between the first surface end andthe second surface end extends into the insert body. The curved portionis shaped to contact a bone engagement member. The cavity is definedwithin the insert body and includes a first cavity opening defined bythe first surface. The cavity defines a first cavity region and a secondcavity region each coextensive with a third cavity region. The firstcavity region and second cavity region each have a cavity diametergreater than a diameter of a plate engagement member.

According to another aspect of the present disclosure, a shoulderprosthesis system includes a plate, a glenosphere, and an insertcomponent. The plate is configured to be attached to a portion of ashoulder bone, and includes a plate body including a first plate surfaceand a second plate surface opposite the first plate surface. The plateincludes an engagement member extending from the second plate surface.The plate is configured to receive a plurality of plate fixation membersto attach the plate to the portion of shoulder bone. The glenosphereincludes a glenosphere body including a first body surface and aspherical second body surface. The first body surface includes an insertengagement region and a plate engagement region configured to engagewith the engagement member of the plate. The insert component includesan insert body including a first insert surface, a second insertsurface, and a third insert surface. The first insert surface isconfigured to engage the shoulder bone. The second insert surface isconfigured to engage with the insert engagement region of theglenosphere.

Some or all of the systems, components, and subcomponents of the presentdisclosure can be single-use or disposable. Also some or all of thesystems, components, and subcomponents of the present disclosure can bemade of a unitary construction (formed from a single piece of metal,plastic, or other material) or unitary modular construction (pluralityof components and/or subcomponents permanently connected by standardmeans, such as welding or soldering), or of modular construction(plurality of components and/or subcomponents removably connected bystandard means, such as threading or snap-fitting).

These and other features of various embodiments can be understood from areview of the following detailed description in conjunction with theaccompanying drawings.

It is to be understood that both the foregoing general description andthe following detailed description are explanatory and are notrestrictive of the present disclosure, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of an embodiment of a shoulder prosthesissystem including a plate and a glenosphere fixated to a portion of ashoulder bone.

FIG. 2 is a perspective view of an embodiment of the plate andglenosphere of FIG. 1 .

FIG. 3 is a detailed perspective view of an embodiment of theglenosphere of FIG. 1 .

FIG. 4 is a side view transverse to a channel axis of an embodiment ofthe glenosphere of FIG. 1 .

FIG. 5 is another side view transverse to a central axis of anembodiment of the glenosphere of FIG. 1 .

FIG. 6 is another side view facing a cavity of an embodiment of theglenosphere of FIG. 1 .

FIG. 7 is a side view of an embodiment of the plate and glenosphere ofFIG. 1 with fixation members received in each of the plate andglenosphere.

FIG. 8 is a perspective view of an embodiment of the glenosphere of FIG.1 with fixation members received in the plurality of channels of theglenosphere.

FIG. 9 is a perspective view of an embodiment of the plate of FIG. 1with fixation members received in the plate.

FIG. 10 is a detailed perspective view of an embodiment of the plate ofFIG. 1 .

FIG. 11 is another perspective view of an embodiment of the plate ofFIG. 1 .

FIG. 12 is an end view of an embodiment of the plate of FIG. 1 .

FIG. 13 is a block diagram of an embodiment of a method of securing aglenosphere to a portion of a shoulder bone to augment fixation of theglenosphere.

FIG. 14 is a perspective view of an embodiment of a glenosphere having ahood portion.

FIG. 15 is a sectional view of an embodiment of the glenosphere of FIG.14 .

FIG. 16 is an exploded perspective view of an embodiment of aglenosphere, a plate, and a fastening member for fastening theglenosphere to the plate.

FIG. 17 is a perspective view of an embodiment of the plate of FIG. 16 .

FIG. 18 is a sectional view of an embodiment of the glenosphere of FIG.16 .

FIG. 19 is a perspective view of an embodiment of a glenosphere havingan engagement segment for engaging a plate.

FIG. 20 is a perspective view of an embodiment of an assembly of a plateand a glenosphere in which channels of the glenosphere for receivingbone fixation members are oriented parallel to an engagement axis of theglenosphere.

FIG. 21 is an exploded perspective view of an embodiment of the assemblyof FIG. 20 .

FIG. 22 is a sectional view of an embodiment of the glenosphere of FIG.20 .

FIG. 23A is a perspective view of an embodiment of a glenosphereincluding a flange.

FIG. 23B is a front view of an embodiment of the glenosphere of FIG.23A.

FIG. 23C is a cross-sectional view of an embodiment of the glenosphereof FIG. 23A.

FIG. 24 is a rear perspective of an embodiment of a glenosphereincluding a flange.

FIG. 25A is a perspective view of an embodiment of a glenosphere inwhich the flange is offset from a center of the glenosphere.

FIG. 25B is a cross-sectional view of an embodiment of the glenosphereof FIG. 25A.

FIG. 26A is a perspective view of an embodiment of a glenosphereincluding an angled flange.

FIG. 26B is a cross-sectional view of an embodiment of the glenosphereof FIG. 26A.

FIG. 27A is a side view of an embodiment of a glenosphere including acurved flange.

FIG. 27B is a cross-sectional view of an embodiment of the glenosphereof FIG. 27A.

FIG. 28A is an exploded front perspective view of an embodiment of aglenosphere system including an insert component.

FIG. 28B is an exploded top side perspective view of an embodiment ofthe glenosphere system of FIG. 28A.

FIG. 28C is a side view of an embodiment of the glenosphere system ofFIG. 28A when secured to a shoulder bone.

FIG. 28D is a top perspective view of an embodiment of the glenospheresystem of FIG. 28A.

FIG. 28E is a cross-section view of an embodiment of the glenospheresystem of FIG. 28A.

FIG. 28F is an exploded left rear side perspective view of an embodimentof the glenosphere system of FIG. 28A.

FIG. 28G is an exploded left front side perspective view of anembodiment of the glenosphere system of FIG. 28A.

FIG. 29A is a rear perspective view of an embodiment of a glenospheresystem including at least one second channel when secured to a shoulderbone.

FIG. 29B is a rear perspective exploded view of an embodiment of theglenosphere system of FIG. 29A.

FIG. 29C is a rear perspective view of an embodiment of an insertcomponent of the glenosphere system of FIG. 29A.

FIG. 29D is a front right perspective view of an embodiment of theinsert component of FIG. 29C.

FIG. 30A is a rear left perspective exploded view of an embodiment of aglenosphere system including a flange component.

FIG. 30B is a rear right perspective exploded view of an embodiment ofthe glenosphere system of FIG. 30A.

FIG. 30C is a rear top right perspective exploded view of an embodimentof the glenosphere system of FIG. 30A.

FIG. 30D is a front right perspective exploded view of an embodiment ofthe glenosphere system of FIG. 30A.

FIG. 31A is a rear right perspective exploded view of an embodiment of aglenosphere system including an angled surface insert component.

FIG. 31B is a front left perspective exploded view of an embodiment ofthe glenosphere system of FIG. 31A.

FIG. 31C is front perspective exploded view of an embodiment of theglenosphere system of FIG. 31A.

FIG. 32 is a front perspective exploded view of an embodiment of aglenosphere system including an insert component with parallel surfaces.

FIG. 33 is front perspective view of an embodiment of a glenospheresystem including an insert component with parallel surfaces andchannels.

FIG. 34 is a left perspective exploded view of an embodiment of aglenosphere system including an insert component with angled surfacesand channels.

FIG. 35A is a front perspective view of an embodiment of a glenospheresystem including a plurality of insert components.

FIG. 35B is a front exploded perspective view of an embodiment of theglenosphere system of FIG. 35A including an insert component havingcontinuous surfaces.

DETAILED DESCRIPTION

The following detailed description and the appended drawings describeand illustrate various glenosphere systems, methods, and components. Thedescription and drawings are provided to enable one of skill in the artto make and use one or more glenosphere systems and/or components,and/or practice one or more methods. They are not intended to limit thescope of the claims in any manner.

The use of “e.g.” “etc.,” “for instance,” “in example,” and “or” andgrammatically related terms indicates non-exclusive alternatives withoutlimitation, unless otherwise noted. The use of “optionally” andgrammatically related terms means that the subsequently describedelement, event, feature, or circumstance may or may not bepresent/occur, and that the description includes instances where saidelement, event, feature, or circumstance occurs and instances where itdoes not. The use of “attached” and “coupled” and grammatically relatedterms refers to the fixed, releasable, or integrated association of twoor more elements and/or devices with or without one or more otherelements in between. Thus, the term “attached” or “coupled” andgrammatically related terms include releasably attaching or fixedlyattaching two or more elements and/or devices in the presence or absenceof one or more other elements in between. As used herein, the terms“proximal” and “distal” are used to describe opposing axial ends of theparticular elements or features being described in relation toanatomical placement.

A. Glenosphere with Augmented Fixation and Related Methods

In existing solutions, shoulder replacement devices may loseeffectiveness over time due to glenoid bone loss or other deterioration,which may be exacerbated by forces applied to a portion of a shoulderbone by a shoulder prosthesis. Although bone grafts may be used tosupplement engagement between a plate contacting the portion of theshoulder bone and the portion of the shoulder bone, the usefulness ofthe bone grafts may be reduced by bone loss. The present solutionprovides systems, methods, and apparatuses for improving shoulderprostheses by augmenting fixation of a glenosphere to the portion of theshoulder bone. The glenosphere includes a body, a first surface, asecond surface, a cavity, and a plurality of channels. The body definesa central axis passing through the body. The first surface includes afirst rim and a second rim. The first rim is positioned radially outwardfrom the second rim relative to the central axis. The second surfaceextends from the first rim of the first surface. The second surface hasa convex shape. The cavity extends into the body from the first surface.The cavity includes a cavity wall extending from the second rim in adirection substantially parallel to the central axis into the body and acavity surface. The cavity is configured to receive a plate defining aninterference space. The plurality of channels extend from the firstsurface through the body to the second surface. Each channel defines afirst opening positioned on the first surface between the first rim andthe second rim and defines a second opening positioned on the secondsurface. Each channel is configured to be oriented to define a channelaxis that passes through the channel and is positioned to be outside ofthe interference space when the plate is received in the cavity. Aplurality of glenosphere fixation members can be received through theplurality of channels to secure the glenosphere to the portion of theshoulder bone. As such, fixation of the glenosphere to the shoulder canbe augmented, in order to mitigate glenoid bone loss or other changes tothe shoulder joint that would otherwise deteriorate the shoulder jointand reduce the effectiveness of the shoulder prosthesis.

Referring to FIG. 1 , a perspective view of a shoulder prosthesisincluding a glenosphere 100 and a plate 200 fixated to a portion 10 of ashoulder bone is shown. The glenosphere 100 is coupled to the plate 200,such as by engagement of an engagement member of the glenosphere 100 andan engagement member of the plate 200. The glenosphere 100 can beoriented and further secured (e.g., fixated, attached, etc.) to theportion 10 outside of portions of bone different from portions of boneat which the plate 200 is attached. In some embodiments, securing theglenosphere to the portion 10 of the shoulder bone reduces stress on theportion 10 of the shoulder bone to mitigate glenoid bone loss damage.

In various embodiments, the glenosphere 100 is configured to be coupledto any of a variety of plates. For example, the plates can includevarious shapes (e.g., cylindrical, ovoid, rectangular, convex, concave,etc.). The plate can be formed as a single plate (e.g., similar oridentical to plate 200 as shown in FIG. 1 ), or can be formed as aplurality of plates (e.g., a plurality of plates fixed to discreteportions of a shoulder bone). The glenosphere 100 can be configured tocouple to plates in various ways, such as by using a variety offastening members and/or engagement members (e.g., screws, bolts, pressfits, frictional engagements, tabs, locks, etc.). In some embodiments,the glenosphere 100 can be configured to include one or more engagementfeatures that are sized, configured or designed to engage withcorresponding engagement features of a corresponding plate with whichthe glenosphere is to be coupled.

In some embodiments, the glenosphere 100 acts as a ball in aball-and-socket joint between a humerus (not shown) and the shoulderbone. By augmenting the fixation of the glenosphere to the shoulderbone, the present solution can improve the effectiveness of a shoulderprosthesis for a patient, including improving the patient's ability touse their humerus. For example, augmenting the fixation of theglenosphere 100 to the shoulder bone can facilitate orienting theglenosphere 100 in an anatomic orientation, allowing a patient to usetheir humerus in an anatomic or natural range of motion.

In some embodiments, the glenosphere 100 and plate 200 are provided in asurgical kit or otherwise paired together, such as for being secured tothe portion 10 of the shoulder bone in a single procedure. In someembodiments, the plate 200 has already been secured to the portion 10,and the glenosphere 100 is designed to complement the plate 200, toaugment fixation of the plate 200, to replace an existing shoulderprosthesis component (e.g., an existing glenosphere), etc. Theglenosphere 100 can be customized or otherwise designed to match aparticular plate 200. The glenosphere 100 can have broad or universalcompatibility with various plates 200.

In some embodiments, the glenosphere 100 is customized or otherwisedesigned for compatibility with a particular patient. For example, amodel of the glenosphere 100 can be generated based on informationregarding the shoulder of a patient, such as imaging data (e.g., MRIdata, etc.) and/or based on information regarding the plate 200. Theinformation can indicate target locations on the portion 10 for securingthe glenosphere 100 to the portion 10. For example, the information caninclude target locations on a surface of the portion 10 through whichfixation members will be driven to secure the glenosphere 100 to theportion 10. The information can indicate an interference space of theplate 200. The information can indicate locations on the portion 10where bone loss has occurred or may occur, such as for avoiding theselocations when securing the glenosphere 100 to the portion 10. Forexample, based on information regarding the shoulder of the patientand/or the plate 200, the glenosphere 100 can be manufactured such thatfixation members used to secure the glenosphere 100 to the portion 10are positioned outside of the interference space of the plate 200 andenter the portion 10 at locations that are stable with regards to boneloss. In some embodiments, this can be achieved by orienting a pluralityof channels of the glenosphere 100 in which the fixation members arereceived. When the plate 200 is received in the glenosphere 100 and thefixation members are received in the plurality of channels, the fixationmembers pass through the channels, outside of the interference space,and can enter the portion 10 at locations outside of the interferencespace.

Referring to FIG. 2 , a detailed perspective view of the glenosphere 100and plate 200 when the plate 200 is received in the glenosphere 100 isshown. The glenosphere 100 includes a body 104. The body defines acentral axis 108. The body 104 can include a variety of shapes. Forexample, in various embodiments, the body 104 can include a sphericalshape, a substantially cylindrical shape, or any other shape allowingthe glenosphere 100 to act as part of a shoulder prosthesis. The body104 can be formed of a variety of materials, including bio-compatiblematerials, such as a metal, alloy, or ceramic material.

The central axis 108 of the glenosphere 100 generally defines an axistransverse to which the plate 200 is received in the glenosphere 100(e.g., when the glenosphere 100 is positioned such that the glenosphere100 contacts the plate 200, the plate 200 is at least partiallypositioned within a feature of the glenosphere 100 such as cavity 128shown in FIGS. 3-6 , etc.). For example, the glenosphere 100 may includereceiving surface or an engagement member, such as an engagement memberthat allows for a Morse taper between the glenosphere 100 and the plate200 that extends from the glenosphere 100 in a direction parallel orsubstantially parallel to the central axis 108. The central axis 108 canpass through a center or close to a center or central plane of theglenosphere 100.

The glenosphere 100 includes a first surface 112 including a first rim116 and a second rim 120. The first rim 116 is positioned radiallyoutward from the second rim 120, such as by being radially outwardrelative to the central axis 108 and/or where the central axis 108intersects the first surface 112. In some embodiments, the first surface112 includes material configured to contact the portion 10 of theshoulder bone. For example, the first surface 112 can include a texturedsurface configured to engage the portion 10 to couple the glenosphere100 to the portion 10.

The glenosphere 100 includes a second surface 124. The second surface124 extends from the first rim 116 of the first surface 112. Forexample, as shown in FIG. 2 , each of the first rim 116 and the secondsurface 124 include an arcuate shape, such that an edge of the secondsurface 124 follows the arcuate shape of the first rim 116.

The second surface 124 has a convex shape. The convex shape of thesecond surface 124 allows the second surface 124 to engage otherportions of a shoulder prosthesis system, such as a joint attached to ahumerus bone (not shown). For example, the convex shape of the secondsurface 124 can provide the glenosphere 100 with a spherical orsubstantially spherical shape, in order to act as a ball in aball-and-joint prosthesis system such that the joint can articulateabout the second surface 124.

In some embodiments, as shown, e.g., in FIGS. 2-8 , the glenosphere 100can have a shape that is greater than or equal to a hemispherical shape.For example, the glenosphere 100 occupies a greater volume than to ahemisphere defined by radii extending from a center of the glenosphere100 (the center can be defined by a point at which radii of theglenosphere 100 intersect, at which radii of a full sphere superimposedon the glenosphere 100 would intersect, etc.). By having a shape that isgreater than or equal to a hemispherical shape, the glenosphere 100 canbe configured to contact the baseplate 200 further away from the portion10, providing greater clearance for the glenosphere 100 relative to theshoulder bone when the glenosphere 100 is fixated to the portion 10, andcan otherwise improve the kinematics of the glenosphere 100 for thepatient.

In some embodiments, as shown, e.g., in FIG. 3 , the central axis 108 islocated or shifted towards an outer portion of the glenosphere 100(e.g., towards the second surface 124, away from a plurality of channels160 as shown in FIG. 3 and described herein) relative to an axis thatwould pass through the center of the glenosphere 100 (e.g., the centralaxis 108 is positioned between an axis that would pass through thecenter of the glenosphere 100 and an axis that would be tangential tothe second surface 124). By having the central axis 108 located towardsthe outer portion of the glenosphere 100, the glenosphere 100 can haveimproved kinematics for the patient.

The glenosphere 100 can be configured to receive one or more glenospherefixation members 140. The glenosphere fixation members 140 areconfigured to secure the glenosphere 100 to the portion 10 of theshoulder bone. The glenosphere fixation members 140 are configured to bepositioned outside an interference space of the plate 200. Theglenosphere fixation members 140 can include engagement features (e.g.,threads on an outer surface of the glenosphere fixation members 140) orother elements allowing the glenosphere fixation members 140 to bedriven through the portion 10 to be frictionally secured in the shoulderbone. The glenosphere fixation members 140 can include a variety ofcomponents, including fasteners, screws (e.g., compression screws,tapered screws), bolts, etc.

The glenosphere 100 includes a plurality of channels 160. The pluralityof channels 160 extend from the first surface 112 through the body 104to the second surface 124. Each channel 160 defines a first opening(e.g., first opening 164 shown in FIG. 3 ) positioned on the firstsurface 112, and a second opening 168 positioned on the second surface124. The plurality of channels 160 allow for a corresponding pluralityof glenosphere fixation members 140 to be received through the pluralityof channels 160. The channels 160 can be configured to receivecorresponding glenosphere fixation members 140 such that the glenospherefixation members 140 can be attachable to portions of bone that aredifferent from portions of bone at which attachment fixation membersthat secure an attachment structure (e.g., the plate 200) to the boneare attached to the bone.

In various embodiments, the glenosphere 100 can include various numbersof channels 160 (e.g. 1, 2, 3, 4, 5, etc.). One or more of the pluralityof channels 160 can be configured to receive a glenosphere fixationmember 140. For example, one or more of the plurality of channels 160can include engagement receiving features (e.g., slots, threads locatedon the surface of channels 160 extending from channels 160, etc.)configured to reciprocally engage engagement features of the glenospherefixation members 140.

In some embodiments, fewer glenosphere fixation members 140 are receivedin the channels 160 than the number of channels 160. For example, theglenosphere 100 can include four channels 160 configured to receiveglenosphere fixation members 140. Depending on factors including thepositions at which plate fixation members 208 attach the plate 200 tothe bone, the shape of the interference space defined by the plate 200(or other components such as the bone engagement member 204, the platefixation members 208, etc.), and/or the condition of a surface of theportion 10 (e.g., a susceptibility to glenoid bone loss), threeglenosphere fixation members 140 can be received in three of the fourchannels 160 such that the glenosphere fixation members 140 pass outsideof the interference space to enter the portion 10 of the shoulder bone.Other such combinations of glenosphere fixation members 140 and channels160 may be used.

In some embodiments, target locations on the portion 10 of the shoulderbone at which glenosphere fixation members 140 are to be secured to theportion 10 are determined based on at least one of imaging data of theportion 10 and a bone loss model of the portion 10. The glenosphere 100can be configured or designed (e.g., designed in a custom design processto match a particular portion 10 and/or plate 200) and manufactured sothat glenosphere fixation members 140 received through the channels 160can be secured to the portion 10 at the target locations. Theglenosphere 100 can be oriented (e.g., positioned and/or rotated) sothat glenosphere fixation members 140 received through the channels 160can be secured to the portion 10 at the target locations. Theglenosphere 100 can be configured such that the channels 160 havechannel axes 172 that do not intersect plate fixation members 208received in the plate 200 based on a geometry of the plate 200 and theplate fixation members 208.

In some embodiments, the channels 160 are tapered (e.g., across-sectional area of a channel 160 changes from first opening 164 tosecond opening 168). For example, the channels 160 can be tapered todecrease in cross-sectional area from the second opening 168 to thefirst opening 164, which can facilitate orienting the glenosphere 100 byusing the first opening 164 as a focus point, and which can improve thefrictional fit between the channel 160 and a glenosphere fixation member140.

The plate 200 can include a bone engagement member 204. The boneengagement member 204 extends from the plate 200. In some embodiments,the bone engagement member 204 extends along the central axis of theglenosphere 100 when the plate 200 is received in the glenosphere 100.In some embodiments, the bone engagement member 204 is offset and/orskew relative to the central axis of the glenosphere 100 when the plateis received in the glenosphere 100. In some embodiments, the boneengagement member 204 is integrally formed with the plate 200. In otherembodiments, the bone engagement member 204 can be separate from theplate 200 and received in an opening of the plate 200.

The bone engagement member 204 can be configured to secure the plate 200to the portion 10 of the shoulder bone. The bone engagement member 204can include engagement features (e.g., threads located on an outersurface of the bone engagement member 204) or other elements allowingthe bone engagement member 204 to be driven through a surface of theportion 10 to be frictionally secured in the shoulder bone.

The plate 200 can be configured to receive plate fixation members 208.The plate fixation members 208 can be similar or identical to theglenosphere fixation members 140. The plate fixation members 208 canextend in a direction parallel to the bone engagement member 204 fromthe plate 200. The plate fixation members 208 can extend in directionsthat are offset and/or skew relative to the bone engagement member 204.In some embodiments, the plate fixation members 208 are oriented at anoffset angle relative to the central axis 108 when the plate 200 isreceived in the cavity 128 of the glenosphere 100. In variousembodiments, the plate 200 can be configured to receive various numbersof plate fixation members 208 (e.g. 1, 2, 3, 4, 5, etc.).

In some embodiments, the plate fixation members 208 and glenospherefixation members 140 can include engagement features having oppositedirections (e.g., threads located on outer surfaces of the platefixation members 208 and glenosphere fixation members 140 havingopposite threadforms), such that forces applied to the plate 200 and theglenosphere 100 can be distributed via the plate 200 or the glenosphere100 depending on the direction of the forces.

In some embodiments, the plate 200 can define an interference space. Theinterference space indicates a region in space in which fixation membersused to secure the glenosphere 100 to the portion 10 (e.g., glenospherefixation members 140), do not pass through. As such, the glenosphere 100can be oriented so that the glenosphere 100 does not interfere with thefixation of the plate 200 to the portion 10. Instead, the fixation ofthe glenosphere 100 to the portion 10 is augmented by the glenospherefixation members 140, which strengthens the connection between the plate200 and glenosphere 100 to the portion 10, helping to mitigate bone lossdamage. In some embodiments, the interference space extends to a surfaceof the portion 10. In some embodiments, such as if a plate is formed asa plurality of plates, the interference space can include a plurality ofregions, such as a plurality of discrete and/or overlapping regionscorresponding to one or more of the plurality of plates.

In some embodiments, the plate fixation members 208 of the plate 200 candefine the interference space. For example, the interference space caninclude a volume occupied by the plate fixation members 208, such as avolume exactly occupied by the plate fixation members 208, a volumesubstantially occupied by the plate fixation members 208, a volumeexactly occupied by the plate fixation members 208 supplemented by aboundary region (e.g., a boundary region consisting of a volume of spaceextending outward from the plate fixation members 208, such as by afractional distance relative to a dimension of the plate fixationmembers 208), etc. The interference space can also be at least partiallydefined by the bone engagement member 204 of the plate 200. In someembodiments, the interference space can be a volume or region within thebone to which the plate 200 is coupled that is occupied by the platefixation members

In some embodiments, the interference space is defined to include atleast a portion of an interior volume between the plate fixation members208, such that the glenosphere 100 can be oriented such that anyglenosphere fixation members 140 are positioned outside of multipleplate fixation members 208. In other embodiments, the interference spaceis defined to exclude at least a portion of an interior volume betweenthe plate fixation members 208, such that the glenosphere 100 can beoriented such that at least one glenosphere fixation member 140 can bepositioned at least partially between at least two plate fixationmembers 208.

Referring now to FIGS. 3-6 , the glenosphere 100 is shown isolated fromthe plate 200 and any fixation members. The glenosphere 100 includes acavity 128. The cavity 128 extends into the body from the first surface112. The cavity is defined by a cavity wall 132 that extends from thesecond rim 120 of the first surface 112 in a direction substantiallyparallel to the central axis 108 to a cavity surface 136, and by thecavity surface 136.

The cavity 128 is configured to receive the plate 200 such that thecavity surface 136 contacts a surface of the plate 200 (e.g., secondplate surface 216 shown in FIG. 10 , etc.). For example, the cavity 128can include a shape that matches at least a part of a shape of thesecond plate surface 216 of the plate 200. The cavity 128 can include acircumference that corresponds to a circumference of the plate surface216. As shown in FIGS. 3 and 6 , the cavity 128 includes a generallycircular shape configured to match a shape of the plate 200, such thatthe cavity wall 132 can engage an outer edge of the plate 200.

As shown in FIG. 3 , the cavity 128 is positioned such that the centralaxis 108 defined by the body 104 passes through the cavity 128transverse (e.g., perpendicular) to the cavity surface 136. As such, theplate 200 may be received in the cavity 128 such that a bone engagementmember of the plate 200 is positioned along the central axis 108.

In some embodiments, the cavity surface 136 of the cavity 128 includesfrictional elements configured to frictionally engage the second platesurface 216 of the plate 200. For example, the cavity surface 136 caninclude a textured surface that enhances frictional engagement betweenthe cavity 128 and the plate 200. The frictional engagement between thesurfaces can help distribute forces applied to the glenosphere 100 tothe plate 200 in order to distribute the forces transferred to theportion 10 of the shoulder bone. In some embodiments, the cavity 128includes locking elements (e.g., hooks, latches, flanges, etc.)configured to engage a corresponding locking element (e.g., hooks,latches, flanges, etc.) of the plate 200. For example, orienting theglenosphere 100 so that the cavity 128 receives the plate 200 caninclude aligning the locking elements and pressing together theglenosphere 100 to the plate 200 or rotating the glenosphere 100relative to the plate 200 to lock the glenosphere 100 to the plate 200.

In some embodiments, the first surface 112 includes a first region 176substantially perpendicular to the central axis 108 and a second region180 disposed at an angle to the first region 176. For example, thesecond region 180 can form an obtuse angle with the first region 176. Alength of the cavity wall 132 between the cavity surface 136 and thefirst surface 112 can increase continuously between the first region 176and the second region 180, such that the cavity surface 136 maintains aflat or planar shape adjacent to both the first region 176 and thesecond region 180. A first portion of the cavity wall 132 extends from aportion of the second rim 120 adjacent to the first region 176, and asecond portion of the cavity wall 132 extends from a second portion ofthe second rim 120 adjacent to the second region 180.

In some embodiments, one or more of the first openings 164 of theplurality of channels 160 are positioned on the second region 180. Asshown in FIG. 3 , each of the first openings 164 of the plurality ofchannels 160 are positioned on the second region 180. Positioning thefirst openings 164 on the second region 180 can facilitate orienting theglenosphere 100 such that glenosphere fixation members (e.g.,glenosphere fixation members 140 shown in FIG. 2 , etc.) can bepositioned to pass through the plurality of channels 160 outside of aninterference space defined by the plate 200. In some embodiments, atleast one of the first openings 164 is positioned on the first region176 so as to orient at least one glenosphere fixation member 140 at anangle to other glenosphere fixation members 140.

The plurality of channels 160 define a plurality of channel axes 172passing through the plurality of channels 160. As shown in FIG. 3 , thechannel axes 172 are positioned perpendicular to the first surface 112.The plurality of channels extend from a first opening 164 on the firstsurface 112 to a second opening 168 on the second surface 124. As shownin FIGS. 3-6 , the channel axes 172 can be oriented parallel to oneanother. In various embodiments, the orientation of the plurality ofchannels 160 and thus of the channel axes can be varied in order toalter the direction that glenosphere fixation members 140 passingthrough the plurality of channel axes 172 extend. For example, whileFIG. 3 shows the channels 160 oriented perpendicular to the firstsurface 112 (e.g., the channels axes 172 are perpendicular to the firstsurface 112), in other embodiments, the channels 160 can be oriented atan acute angle to the first surface 112. For example, orienting achannel 160 at an acute angle to the first surface 112, so that adistance between the channel axis 172 of the channel 160 and the centralaxis 108 decreases as the axes 108, 172 extend away from the glenosphere100 (e.g., extend towards the portion 10 of the shoulder bone, extend ina direction substantially perpendicular to first surface 112 or secondsurface 116, etc.), allows the glenosphere fixation members 140 to besecured to the portion 10 at locations that are relatively close towhere the plate 200 is secured to the portion 10, which can reduce thesurface area of the portion 10 required for the shoulder prosthesis. Inanother example, orienting a channel 160 at an acute angle to the firstsurface 112, so that a distance between the channel axis 172 of thechannel 160 and the central axis 108 increases as the axes 108, 172extend away from the glenosphere 100 (e.g., extend towards the portion10 of the shoulder bone, extend in a direction substantiallyperpendicular to first surface 112 or second surface 116, etc.), allowsthe glenosphere fixation members 140 to be secured to the portion 10 atlocations that are relatively close to where the plate 200 is secured tothe portion 10, which can reduce the stress on the surface of portion 10required for the shoulder prosthesis. In some embodiments, at least onethe plurality of channels 160 is oriented perpendicular to the firstsurface 112, and at least one of the plurality of channels 160 isoriented at an acute angle to the first surface 112.

In embodiments in which the glenosphere 100 includes a first surface 112having a first region 176 and a second region 180 disposed at an angleto the first region 176, the channel axes 172, which are perpendicularto the first surface 112 and the second region 180, are oriented at anangle to the central axis 108. For example, if the second region 180 isdisposed at an obtuse angle relative to the first region 176, thechannel axes 172 will be oriented at an acute angle relative to thecentral axis 108. In this manner, the glenosphere fixation members 140received through the plurality of channels 160 and positioned along thechannel axes 172 can be positioned outside of the interference space ofthe plate 200 yet engage a portion of the portion 10 proximate to whereplate engagement members of the plate engage the portion 10.

Referring further to FIGS. 3 and 6 , in some embodiments, the cavity 128includes an inner cavity portion 184. The inner cavity portion 184 caninclude a second cavity wall 186 and a second cavity surface 188. Theinner cavity portion 184 can be configured to receive a componentextending from a surface of a plate (e.g., plate 200). For example, theinner cavity portion 184 can act as an engagement member for engaging acorresponding engagement member of the plate 200 (e.g., engagementmember 236 as shown in FIG. 11 , etc.). For example, the inner cavityportion 184 can be or include a first engagement member configured toengage a second engagement member 236 of the plate 200. In someembodiments, the inner cavity portion 184 is configured to form a Morsetaper with the engagement member 236 of the plate 200. In someembodiments, the inner cavity portion 184 and engagement member 236include complementary engagement elements (e.g., hooks, latches,flanges, threaded couplings, etc.) for securing the glenosphere 100 tothe plate 200.

Referring now to FIGS. 7-9 , the glenosphere 100 and plate 200 are shownin various configurations with fixation members. In FIG. 7 , an end viewof the glenosphere 100 and plate 200 with fixation members is shown. Theplurality of glenosphere fixation members 140 are received in theplurality of channels 160 of the glenosphere 100. The plurality of platefixation members 208 extend from the plate 200. In FIG. 8 , aperspective view of the glenosphere 100 with glenosphere fixationmembers 140 is shown. In FIG. 9 , a perspective view of the plate 200with plate fixation members 208 is shown.

In FIG. 7 , the glenosphere 100 and plate 200 are shown looking down thecentral axis (e.g., central axis 108 shown in FIG. 8 ) of theglenosphere 100, and the bone engagement member 204 of the plate 200 isoriented along the central axis 108. In other words, an axis of the boneengagement member 204 and the plate 200 is coaxial with the central axis108 of the glenosphere 100. As further shown in FIG. 7 , the pluralityof plate fixation members 208 are oriented in the same direction as thebone engagement member 204, such that they are parallel to and offsetfrom the central axis 108 and the bone engagement member 204.

The plurality of glenosphere fixation members 140 can extend at an anglerelative to the central axis 108 and the bone engagement member 204 andplate fixation members 208. For example, as shown in FIGS. 7 and 8 , thefirst surface 112 of the glenosphere 100 includes a first region 176 anda second region 180 oriented at an obtuse angle relative to the firstregion 176. The plurality of first openings 164 of the plurality ofchannels 160 are positioned in the second region 180 of the firstsurface 112, such that the plurality of glenosphere fixation members 140extend out from the glenosphere 100 at an angle to the central axis 108,and thus at an angle relative to components extending from the plate 200when the plate 200 is received in the glenosphere 100. The glenospherefixation members 140 are configured to extend out of the first openings164, past an interference space of the plate 200 when the plate 200 isreceived in the glenosphere 100, to secure the glenosphere 100 to theportion 10 of the shoulder bone.

Referring further to FIG. 9 , the plate fixation members 208 extend fromthe plate 200 in the same direction as the bone engagement member 204.The plate fixation members 208 can have a variety of lengths. Forexample, the plate fixation members 208 can have a similar length to thebone engagement member 204, such as by having a length that is slightlyless than the length of the bone engagement member 204. The length ofthe plate fixation members 208 can be selected based on imaging dataindicating compatibility of the portion 10 of the shoulder bone forreceiving an engagement member.

Referring now to FIGS. 10-12 , the plate 200 is shown isolated from theglenosphere 100 and any fixation members. The plate 200 includes a firstplate surface 212 on a side of the plate 200 from which the boneengagement member 204 extends, and a second plate surface 216 on anopposite side of the plate 200 from the first plate surface 212. A platebody 220 is disposed between the first plate surface 212 and the secondplate surface 216. The plate body 220 includes a plate wall 224 along anouter portion (e.g., circumference) of the plate body 220. In someembodiments, the plate body 220 and plate wall 224 are configured to bereceived in a cavity of a glenosphere such that the plate wall 224 ispositioned flush against the a wall of the cavity (e.g., cavity 128,cavity wall 132 of glenosphere 100 as shown in FIG. 3 , etc.). Thesecond plate surface 216 of the plate 200 can be positioned flushagainst a surface of the cavity 128 (e.g., cavity surface 136 as shownin FIG. 3 , etc.).

The plate 200 includes a plurality of plate channels 228. Each platechannel 228 extends from an opening on the first surface 212 to anopening on the second plate surface 216. The plurality of plate channels228 are configured to receive the plurality of plate fixation members(e.g., plate fixation members 208 shown in FIG. 9 , etc.). The pluralityof plate channels 228 can include engagement receiving surfaces (e.g.,threaded surfaces) configured to receive and engage with engagementfeatures (e.g., threads) of the plate fixation members 208 in order tofrictionally couple the plate 200 to the plate fixation members 208 asthe plate 200 is secured to the portion 10 of the shoulder bone. Theplurality of plate channels 228 can be oriented transverse (e.g.,perpendicular) to a plate axis 232 along with the bone engagement member204 is oriented, such that the plate fixation members 208 can beoriented parallel to the bone engagement member 204 when the platefixation members are received through the plurality of plate channels228. In various embodiments, the plurality of plate channels 228 can beoriented at various angles relative to the plate axis 232, and can beoriented at heterogeneous angles relative to one another. For example,each of the plurality of plate channels 228 can be oriented at an angleoffset to the plate axis 232. Each of the plurality of plate channels228 can be oriented at an angle offset to the central axis 108 when theplate 200 is received in the cavity 128 of the glenosphere 100.

As shown in FIGS. 10-12 , the bone engagement member 204 is integrallyformed with the plate 200. In some embodiments, the plate 200 caninclude a receiving surface configured to receive the bone engagementmember 204.

In some embodiments, as shown in FIGS. 11 and 12 , the plate 200includes an engagement member 236 configured to engage the plate 200 toa glenosphere 100 such that the plate 200 can be secured and received ina cavity of the glenosphere 100 (e.g., by engaging inner cavity portion184 of cavity 128 of glenosphere 100 as shown in FIG. 6 , etc.). Forexample, the glenosphere 100 and plate 200 can be secured to one anotherby engaging the engagement member 236 and the cavity 128 (e.g., byforming a Morse taper between the inner cavity portion 184 of the cavity128 and the engagement member 236). The engagement member 236 can extendfrom the second plate surface 216 of the plate 200 in an oppositedirection as the bone engagement member 204. For example, the engagementmember 236 can be oriented along the plate axis 232 such that the boneengagement member 204 and the engagement member 236 are coaxial with acentral axis (e.g., central axis 108 shown in FIG. 3 , etc.) of theglenosphere 100 when the plate 200 is received in the glenosphere 100.

In some embodiments, the plurality of channels 160 include markingsconfigured to facilitate orienting the glenosphere 100 when receivingthe plate 200 such that glenosphere fixation members 140 passed throughthe glenosphere 100 will be positioned outside of the interferencespace. For example, the markings can be positioned parallel to thechannel axes 172 passing through the channels 160, such that a line ofsight following the markings can indicate an intersection with theinterference space of the plate 200. The markings can includefluorescent material or other material configured to visually aidorientation of the glenosphere 100.

In some embodiments, channel guides having similar form factors to theplurality of glenosphere fixation members 140 can be used to facilitateorienting the glenosphere 100. For example, the guides can be insertedthrough the plurality of channels 160 in a similar manner as theglenosphere fixation members 140, in order to determine whether theglenosphere fixation members 140 would intersect or pass outside of theinterference space of the plate 200. The channel guides can be removablyinserted in the plurality of channels 160 so as to facilitate quickorientation of the glenosphere 100 prior to securing of the glenosphere100 using the glenosphere fixation members 140.

Referring now to FIG. 13 , a block diagram of a method 400 of securing aglenosphere to a portion of a shoulder bone and to a plate fixated tothe portion of the shoulder bone, such as a method that is performed aspart of a shoulder arthroplasty, is shown. The method 400 can beimplemented using any of the devices and systems disclosed herein,including the glenosphere 100 and plate 200 described with regards toFIGS. 1-12 . A variety of actors can perform the method 400, includingbut not limited to a medical care professional (e.g., doctor, nurse),etc.

At 410, a glenosphere is positioned adjacent to a plate. The plate isfixated to a portion of a shoulder bone. The glenosphere includes a bodydefining a central axis passing through the body. The glenosphereincludes a first surface including a first rim and a second rim, and asecond surface extending from the first rim. The second surface has aconvex shape. The glenosphere includes a cavity extending into the bodyfrom the first surface. The cavity is configured to receive the plate.The glenosphere includes a plurality of channels extending from thefirst surface through the body to the second surface. Each channeldefines a first opening positioned on the first surface between thefirst rim and the second rim, defines a second opening positioned on thesecond surface, and defines a channel axis passing through the channel.Positioning the glenosphere can include holding the glenosphere adjacentto the plate, such as within a distance of the plate such thatcomponents of the plate are visible through the channels of theglenosphere. For example, a surgeon or other medical professional canposition the glenosphere adjacent to the plate, so that the surgeon canmanipulate the glenosphere in relation to the plate.

At 420, the glenosphere is oriented relative to the plate. For example,the glenosphere can be oriented such that a central axis of theglenosphere is coaxial with a plate axis of the plate. In someembodiments, the plate is already secured to the portion of the shoulderbone, and thus the glenosphere can be oriented relative to a fixed plateand fixed plate axis of the plate. The glenosphere can be oriented suchthat the glenosphere will be in an anatomic position, allowing for anatural range of motion when the shoulder arthroplasty is complete. Insome embodiments, the glenosphere can be oriented off-axis or otherwiseoffset from an anatomic position, allowing for a different range ofmotion. For example, a surgeon or other medical professional can orientthe glenosphere relative to the plate.

At 430, the channel axes of the glenosphere are positioned outside of aninterference space of the plate. The interference space can be definedby plate fixation members and/or a bone engagement member of the plate.The interference space can include an exact volume of the plate fixationmembers and/or bone engagement member, or can include a volume lesser orgreater than these components. Positioning the channel axes outside ofthe interference space facilitates positioning glenosphere fixationmembers such that the glenosphere fixation members do not collide withthe plate fixation members or the bone engagement member. Theinterference space can be determined visually, by using marking guides,or by a combination thereof. For example, a surgeon or other medicalprofessional can determine an extent of the interference space, andposition the glenosphere—and thus the channels axes which are fixedrelative to the glenosphere—such that the channel axes are positionedoutside of the interference space.

In some embodiments, positioning the channel axes includes positioningmarking guides in the plurality of channels to align the plurality ofchannels. For example, the marking guides may indicate a direction ofthe channel axes. In some embodiments, positioning the channel axesincludes removably receiving channel guides in the plurality ofchannels. The channel guides can include a form factor similar oridentical to glenosphere fixation members. For example, the channelguides can be received in the plurality of channels in a similarorientation as the glenosphere fixation members would be received, andthe orientation of the glenosphere can be adjusted until the channelguides (and thus the channel axes) are positioned outside of theinterference space. For example, orienting the glenosphere can includereceiving a plurality of channel guides in the plurality of channels andmodifying the orientation of the glenosphere until each of the channelguides is positioned outside of the interference space. A surgeon orother medical professional can insert the channel guides through theplurality of channels and modify the orientation of the glenospherebased on whether each of the channel guides are positioned outside ofthe interference space.

In some embodiments, positioning the channel axes includes orienting theglenosphere such that the channel axes are positioned outside theinterference space (e.g., the channel axes do not intersect theinterference space). In some embodiments, positioning the channel axesincludes orienting the glenosphere such that a volume about eachrespective channel axis is positioned outside of the interference space(e.g., a volume about each respective channel axis does not intersectthe interference space). The volume about each respective channel axiscan be an extrapolation of the respective channels, such as acylindrical volume extending from the openings of the channels.

In some embodiments, positioning the channel axes includes positioningthe channel axes based on an offset between a first position of theglenosphere before the plate is received in the glenosphere, and asecond position of the glenosphere after the plate is received in theglenosphere. For example, in the first position, the glenosphere may bepositioned and oriented such that the channel axes intersect theinterference space, yet as the plate is received in the glenosphere(such as by decreasing a distance between the glenosphere and the plateby moving the glenosphere towards the portion of the shoulder bone andthe plate along the plate axis of the plate), the channel axes becomepositioned outside of the interference space. In some embodiments,channel guides are used that have a shape and a guide length that isoffset relative to a length of a glenosphere fixation member, such as anoffset based on a dimension of the cavity of the glenosphere, such thatthe channel guides match the position of the channel axes when the plateis received in the cavity of the glenosphere.

In some embodiments, orienting the glenosphere includes orienting thechannels such that the glenosphere fixation members received in thechannels are attached to a portion of the bone that is different from aportion of the bone at which plate fixation members are attached to thebone. In some embodiments, the interference space is defined by regionsof the bone occupied by the plate fixation members to reduce failure ofthe attachment of the plate to the bone.

At 440, the plate is received into the cavity of the glenosphere. Forexample, the glenosphere can be pressed against the plate such that theplate fits into the cavity. The channel axes will continue to bepositioned outside of the interference space of the plate. In someembodiments, receiving the plate includes engaging a first engagementmember of the glenosphere with a second engagement member of the plate,such as for forming a Morse taper between the glenosphere and the plate.In some embodiments, a cavity wall of the cavity is configured to bepositioned flush against a plate wall of the plate, and a cavity surfaceof the cavity is configured to be positioned flush against a surface ofthe plate when the plate is received in the cavity. For example, asurgeon, having positioned and oriented the glenosphere such that thecentral axis of the glenosphere is coaxial with the plate axis of theplate and the channel axes are positioned outside of the interferencespace, can shift the glenosphere towards the plate and the portion ofthe shoulder bone so that the plate fits into the cavity.

At 450, a plurality of glenosphere fixation members are received in theplurality of channels. Because the glenosphere has been oriented suchthat the channel axes (or volumes about the channel axes) are positionedoutside of the interference space of the plate, the glenosphere fixationmembers when received in the plurality of channels will also bepositioned outside of the interference space. A surgeon can place theglenosphere fixation members into the channels so that the glenospherefixation members are positioned outside of the interference space, andso that the glenosphere fixation members contact the portion of theshoulder bone to which they will be secured.

At 460, the plurality of glenosphere fixation members are secured to theportion of the shoulder bone in order to augment fixation of theglenosphere to the portion of the shoulder bone. The glenospherefixation members can include engagement features (e.g., threads or otherfrictional elements) configured to engage the portion of the shoulderbone. Securing the glenosphere fixation members to the portion of theshoulder bone thus allows for forces transmitted through the glenosphereand plate to the portion of the shoulder bone to be transmitted topositions other than the positions where the bone engagement memberand/or plate fixation members are secured to the portion of the shoulderbone, helping to distribute stresses on the portion of the shoulder boneand mitigate bone loss. For example, a surgeon can use a driver, drill,or other tool to drive the glenosphere fixation members into the portionof the shoulder bone to secure the glenosphere to the portion of theshoulder bone.

In some embodiments, the method includes positioning one or more of theplate and the glenosphere based on imaging data regarding the patient.The imaging data can identify preferred positions for the plate and/orglenosphere in order to provide the shoulder prosthesis system in ananatomic position, to mitigate bone loss or minimize the effects of boneloss, etc. The imaging data can indicate target positions for fixationmembers to be secured to the portion of the shoulder bone.

In some embodiments, a method of securing a glenosphere to a portion ofa shoulder bone and to a plate fixed to the portion of the shoulder boneincludes positioning the glenosphere adjacent to the plate. Theglenosphere can include a body defining a central axis passing throughthe body, a first surface including a first rim and a second rim, asecond surface extending from the first rim of the first surface, thesecond surface having a convex shape, a cavity extending into the bodyfrom the first surface, the cavity configured to receive the plate, anda plurality of channels extending from the first surface through thebody to the second surface. Each channel can define a first openingpositioned on the first surface between the first rim and the secondrim. Each channel can define a second opening positioned on the secondsurface. Each channel can be configured to receive a bone fixationmember configured to secure the glenosphere to the bone. The method caninclude orienting the glenosphere relative to the plate such that eachglenosphere fixation member received by the channels is attachable to aportion of bone that is different from a portion of bone at which platefixation members attach the plate to the bone. The method can includeorienting the glenosphere relative to the plate such that eachglenosphere fixation members received by the channels is attachable to aportion of bone outside of an interference space defined by regions ofbone occupied by plate fixation members that attach the plate to thebone. The method can include receiving the plate into the cavity. Themethod can include receiving a plurality of glenosphere fixation membersin the plurality of channels via the plurality of second openings suchthat the plurality of glenosphere fixation members are positionedoutside of the interference space and contact the portion of theshoulder bone. The method can include securing the plurality ofglenosphere fixation members to the portion of the shoulder bone. Insome embodiments, orienting the glenosphere includes receiving aplurality of channel guides in the plurality of channels and modifyingthe orientation of the glenosphere until each of the channel guides ispositioned outside of the interference space.

B. Further Embodiments of Glenospheres for Augmented Fixation andRelated Methods

Referring now to FIGS. 14-22 , various embodiments of glenospheres foraugmented fixation are illustrated. The glenospheres described withreference to FIGS. 14-22 can be similar to the glenosphere 100 describedwith references to FIGS. 1-13 , and can be configured to engage orotherwise interact with various baseplates, including the plate 200described with reference to FIGS. 1-13 . While the hood feature andoffset engagement axis for glenospheres is described herein withreference to FIGS. 14-22 , the glenosphere 100 of FIGS. 1-13 can alsoinclude a hood or other extended structure (e.g., an hood located in oraround the second region 180 of the glenosphere 100). In someembodiments, a glenosphere having a hood is kinematically advantageousfor a patient with a shoulder prosthesis, as the hood provides anadditional point of contact between the shoulder prosthesis and ashoulder bone to prevent rocking (e.g., unintended movement of theglenosphere, such as rotation in a coronal plane of a body of a patient)as the patient moves an arm connected to the shoulder by theglenosphere. In some embodiments, a glenosphere having an engagementaxis that is offset or spaced from a center of the glenosphere canimprove the kinematics of the glenosphere by increasing the effectivesurface area of the shoulder bone that can be engaged by the glenosphere(or the glenosphere together with the baseplate) without significantlyincreasing the form factor of the glenosphere. In some embodiments, suchas where the glenosphere includes one or more channels for receivingglenosphere fixation members that attach the glenosphere to the shoulderbone, the offset engagement axis and hood may cooperate to providegreater freedom in selecting the orientation of the channels and thusthe portions of the shoulder bone at which the shoulder prosthesis isfixated.

Referring now to FIGS. 14-15 , a glenosphere 500 is shown. Theglenosphere 500 can be similar in structure and function to variousglenospheres described herein (e.g., glenosphere 100). The glenosphere500 includes a body 504 defining a center 506 and an engagement axis 508passing through the body 504. The glenosphere 500 includes a firstsurface 512 including a first rim 516 and a second rim 520, the firstrim 516 positioned radially outward from the second rim 520.

The glenosphere 500 also includes a second surface 524 extending fromthe first rim 516 of the first surface 512. The second surface 524 canhave a convex shape. The second surface 524 can have a spherical shape(e.g., all or substantially all points on the second surface areequidistant from a center point, such as a center of the glenosphere500). The second surface 524 and first surface 512 can extend from eachother along an edge between the first surface 512 and the second surface524, the edge defining a closed path about the body 504. Unlike thesecond surface 124 of the glenosphere 100, the second surface 524 has acontinuous shape (e.g., the second surface 524 is not interrupted byopenings), as the glenosphere 500 does not include a plurality ofchannels for receiving fixation members for attaching the glenosphere500 to the shoulder bone; instead, by coupling to a plate (e.g., plate200), the glenosphere 500 is attached to the shoulder bone.

The center 506 can be defined based on the second surface 524. Forexample, the center 506 can be a point that is equidistant from everypoint of the second surface 524, or a point that is equidistant from themost points on the second surface 524. In some embodiments, where ahumeral component (not shown) is configured to articulate about thesecond surface 524, the center 506 will thus be a center for movement ofthe humeral component.

Similar to the central axis 108 of the glenosphere 100, the engagementaxis can be an axis transverse to which a plate (e.g., plate 200) isreceived in the glenosphere 500 (e.g., transverse to cavity surface 532as described below). In embodiments where the plate includes a boneengagement member (e.g., bone engagement member 204) that is centrallyoriented on the plate, the bone engagement member will align with theengagement axis 508.

In some embodiments, the first surface 512 includes a base surfaceportion 576 and a hood surface portion 580. The hood surface portion 580extends from the base surface portion 576. For example, as shown in FIG.14 , the hood surface portion 580 is continuous with the base surfaceportion 576. A plane 510 can be defined by or include the base surfaceportion 576. For example, as shown in FIGS. 14-15 , the base surfaceportion 576 is substantially planar (e.g., any set of three pointsselected on the base surface portion 576 can define the same plane 510).As shown in FIG. 15 , the hood surface portion 580 can be oriented at anacute angle α relative to the plane 510, and/or at an obtuse angle βrelative to the base surface portion 576. The glenosphere 500 includes ahood portion 582 between the hood surface portion 580 and the plane 510.As shown in FIG. 15 , the hood surface portion 580 is substantiallyplanar (e.g., any set of three points selected on the hood surfaceportion 580 can define the same plane, that plane being oriented at theangle α relative to the plane 510). In some embodiments, the hoodportion 582 is on an opposite side of the center 506 from the engagementaxis 508. In some embodiments, the hood portion 582 is angled (e.g.,angled relative to another portion of the body 504, such as by havingthe hood surface portion 580 oriented at an acute angle α relative tothe plane 510, and/or at an obtuse angle β relative to the base surfaceportion 576).

The glenosphere 500 includes a cavity 528. The cavity 528 is configuredto receive an attachment structure attachable to a bone (e.g., a platesuch as plate 200). The cavity 528 is defined within the body 504. Thecavity includes a perimeter defined by the second rim 520. The cavitycan include a first cavity portion (e.g., a first cavity portionincluding a cavity wall 532 and a cavity surface 536), and a secondcavity portion (e.g., inner cavity portion 584). The first cavityportion can be configured to engage with an attachment structureattachable to the shoulder bone (e.g., the plate 200). In someembodiments, rather than a cavity defined within the body 504 orrecessed from the first surface 512, the glenosphere includes a platereceiver portion of the first surface 512 configured to receive andattach to the plate 200 (e.g., the plate receiver portion can be orinclude an engagement feature configured to couple to an engagementmember of the plate 200).

The inner cavity portion can define an inner cavity surface 586. In someembodiments, the inner cavity surface 586 tapers (e.g., decreases inradius) from a first end at the cavity surface 536 to a second end at asecond surface rim 588 defined on the second surface 524. In someembodiments, an inner body surface 590 is defined in the body 504 andextends between the second surface rim 588 and the inner cavity surface586. In some embodiments, the inner cavity portion 584 is configured toor shaped and sized to engage an engagement member of the attachmentstructure (e.g., to engage second engagement member 236 of plate 200).As shown in FIG. 14 , the inner cavity portion 584 can be oriented alongthe engagement axis 508 (e.g., a plane perpendicular to the inner cavitysurface 586 is also perpendicular to the engagement axis 508). In someembodiments, the cavity 528 (e.g., the cavity wall 532 and/or the innercavity surface 586) has a cylindrical or tapered cylindrical (e.g.,frustrum-like) shape.

In some embodiments, the base surface portion 576 and/or the hoodsurface portion 580 may have non-planar shapes (e.g., curved, concave,etc.). In such embodiments, the hood portion 582 may be defined as aportion of the body 504 between the hood surface portion 580 and theplane 510, or between the hood surface portion 580 and a plane that (1)passes through (or includes) a point (or an arc segment) where the firstsurface 512 intersects the second surface 524, and (2) is parallel tothe cavity surface 536, is perpendicular to the cavity wall 532, and/oris parallel to at least a portion of an intersection of the cavitysurface 536 and the cavity wall 532. The hood portion 582 may thusextend towards a shoulder bone relative to the base surface portion 576,with an end of the hood portion 582 that is furthest from the basesurface portion 576 being closest to the shoulder bone, when a plate isreceived in the glenosphere 500 and the glenosphere 500 and plate areattached to the shoulder bone.

In some embodiments, the base surface portion 576 and the hood surfaceportion 580 can form a single, substantially planar or planar surface(rather than the hood surface portion 580 being at an angle to the basesurface portion 576). If the cavity 528 is recessed from the basesurface portion 576, then the hood portion 582 can be defined as aportion of the body 504 between (1) a plane transverse to the cavity,such as that is tangent to the cavity wall 532 at the farthest pointalong the cavity wall 532 from where the cavity wall 532 is closest tothe second surface 524, and (2) a plane that includes at least somepoints on the cavity surface 536.

The engagement axis 508 can be an axis perpendicular to a surfaceagainst which the plate is received (e.g., cavity surface 532), or anaxis perpendicular to the most points on the surface (e.g., cavitysurface 532). The engagement axis 508 can pass through a channel definedby the inner cavity surface 586, and/or can be defined to be equidistantfrom all (or the most) points on the inner cavity surface 586.

In some embodiments, such as shown in FIG. 15 , the center 506 is spacedby an offset 507 from the engagement axis 508. The offset 507 increasesa distance between the hood surface portion 580 and the engagement axis508, and thus may increase a distance between the hood surface portion580 and a plate received by the glenosphere 500 (e.g., received incavity 528). In some embodiments, the spacing caused by the offset 507allows the hood surface portion 580 to engage portions of a shoulderbone that would not otherwise be accessible.

In some embodiments, the hood surface portion 580 includes a roughsurface, or other surface configured to engage a shoulder bone. Forexample, the hood surface portion 580 can have a surface with acoefficient of friction that is greater than a coefficient of frictionof the base surface portion. The rough surface can facilitate frictionalengagement between the hood surface portion 580 and a first portion ofthe shoulder bone to prevent rocking of the glenosphere 500 when theglenosphere 500 is attached to a second portion of the shoulder bone(e.g., when the glenosphere 500 is coupled to the plate 200, the plate200 being fixated to the second portion of the shoulder bone).

Referring now to FIGS. 16-18 , a glenosphere 600 is illustrated. Theglenosphere 600 can be similar in structure and function to variousglenospheres described herein (e.g., glenosphere 500), with theexception of the cavity of the glenosphere 600 as described furtherbelow. The glenosphere 600 can be configured to attach to a plate 700.The plate 700 can be similar in structure and function to the plate 200.The plate 700 includes a plate body 704 having a first plate surface 708on a same side as a bone fixation member 716, and a second plate surface712 opposite the first plate surface 708. The plate 700 also includes anengagement feature 720. As shown in FIG. 17 , the engagement feature 720includes a recess (e.g., opening, channel).

As shown in FIGS. 16-18 , the glenosphere 600 includes an engagementsegment 684. The engagement segment 684 is shown to have a taperedcylinder shape (e.g., frustrum-like); in various embodiments, theengagement segment 684 can have various shapes, such as an non-taperedcylinder shape (e.g., the diameter of the engagement segment 684 isconstant), a polygonal solid (e.g., rectangular solid), etc. Theengagement segment 684 extends along the engagement axis 608. In someembodiments, the engagement segment 684 tapers from a first engagementend at which the engagement segment 684 intersects (or extends from) thecavity surface 636, to a second engagement end at which the engagementsegment 684 terminates. The engagement segment 684 can be configured toengage (e.g., form a Morse taper, attach to, receive or be received in,couple) the engagement feature 720 of the plate 700.

In some embodiments, the engagement segment 684 includes an outerengagement surface 686. The outer engagement surface 686 can taper froma first end adjacent to the cavity surface 632 to a second end at whichthe outer engagement surface 686 terminates. In some embodiments, theengagement segment 684 (and/or the outer engagement surface 686) extendsfrom the cavity surface 632 out to a plane that is parallel to thecavity surface 632 and tangent to a point on the glenosphere body 604furthest from the cavity surface 632.

The glenosphere 600 can include a second surface 624 that is convex orspherical. The second surface 624 can define a second surface rim 688.The second surface rim 688 is located at the intersection of the secondsurface 624 and an inner body surface 690 defined within the body 604.In some embodiments, the inner body surface 690 is oriented parallel toand/or along the engagement axis 608. For example, when the glenosphere600 receives the plate 700 in the cavity 628, such that the bonefixation member 716 and the engagement feature 720 are each orientedalong the engagement axis 608, the inner body surface 690 will also beoriented along the engagement axis 608, such as for receiving afastening member through the inner body surface 690 to engage (e.g.,attach to) the engagement feature 720 through the inner body surface690.

The inner body surface 690 can be configured to receive a fasteningmember 750. The fastening member 750 can be configured to secure theglenosphere 600 to the plate 700, such as by providing additionalfixation to the fixation between the engagement segment 684 and theengagement feature 720. The inner body surface 690 can have a radius(e.g., a radius defined from the engagement axis 608) that is greaterthan a maximum radius of the fastening member 750.

The engagement segment 684 can define an inner cavity surface 692. Theinner cavity surface 692 can extend through an interior of theengagement segment 684. In some embodiments, the inner cavity surface692 includes a first portion 694 extending from a terminal end of theinner cavity surface and a second portion 696 adjacent to the firstportion 694.

In some embodiments, the second portion 696 is connected to the innerbody surface 690. In some embodiments, the first portion 694 has aradius that is equal to or greater than a radius of threaded features752 of the fastening member 750 (e.g., greater than by less than 10percent, by less than 5 percent, by less than 2 percent), and the secondportion 696 has a radius that is equal to or greater than a maximumradius of the fastening member 750 (e.g., greater than by less than 10percent, by less than 5 percent, by less than 2 percent), such that thefastening member 750 can be inserted through the second surface rim 688into the inner body surface 690 and received in the inner cavity surface692, with the threaded features 752 aligning with the first portion 694.

In some embodiments, a continuous engagement opening (e.g., the openingis defined by one or more surfaces that are adjacent to at least oneother of the surfaces of the opening) in which the fastening member 750can be received and used to attach the glenosphere 600 to the plate 700can be defined by the inner body surface 690 and the inner cavitysurface 692.

Referring now to FIG. 19 , a glenosphere 800 is illustrated. Theglenosphere 800 can be similar to various glenospheres described herein(e.g., glenosphere 800), with the exception of the engagement segment ofthe glenosphere 800. The glenosphere 800 includes a body 804, a secondsurface 824, and a cavity 828 defined at least in part by a cavitysurface 832 and a cavity wall 836. An engagement segment 884 extendsalong an engagement axis 808 from the cavity surface 832. The engagementsegment 884 can taper from a first end at which the engagement segment884 is adjacent to the cavity surface 832 to a second end opposite thefirst end. Unlike the engagement segment 684 of the glenosphere 600, theengagement segment 884 does not include an inner surface in which afastening member can be received. In other words, engagement segment 884is defined by an outer engagement surface 888 that extends from thecavity surface 832 to a transverse engagement surface 886. Thetransverse engagement surface 886 defines a continuous face (e.g., thetransverse engagement surface 886 is solid, does not define an opening,etc.). In addition, unlike the glenosphere 600, the second surface 924is continuous (e.g., does not include an opening or rim such as secondsurface rim 688).

Referring now to FIGS. 20-22 , a glenosphere 900 is illustrated. Theglenosphere 900 can be similar to various glenospheres described herein,with the exception of the orientation of channels for receiving bonefixation members. The glenosphere 900 is shown for engagement with aplate 1000. The plate 1000 can be similar to various plates describedherein (e.g., plate 200, plate 700). The plate 1000 includes a platebody 1004, a first plate surface 1008, and a bone engagement member 1016extending from a same side of the plate body 1004 as the first platesurface 1008.

In some embodiments, the first plate surface 1008 includes engagementfeatures (e.g., relatively rough features as shown in FIGS. 20-21 ) thatfacilitate bone growth, such as for augmenting fixation between theplate 1000 and a shoulder bone. The plate 1000 can receive platefixation members 1050 through plate channels 1052.

The glenosphere 900 includes a body 904 having a first surface 912 and asecond surface 924. The glenosphere 900 defines an engagement axis 908.The glenosphere 900 includes one or more channels 960 that can receivebone fixation members 940 for attaching the glenosphere 900 to ashoulder bone. As shown in FIG. 22 , the channel(s) 960 can be definedby a first channel opening 964 on the first surface 912, a secondchannel opening 968 on the second surface 924, and a channel surface 972connecting the first channel opening 964 to the second channel opening968.

Unlike the channels 160 of the glenosphere 100, the channel 960 isoriented to be parallel to the engagement axis 908, such that a bonefixation member 940 received through the channel 960 would be orientedparallel to the engagement axis 908, and/or the bone engagement member1016 and/or plate fixation members 1050 when the glenosphere 900 isattached to the plate 1000 and the shoulder bone. For example, thechannel 960 can define a channel axis 976 that is parallel to theengagement axis 908. The channel axis 976 can be defined as the axis forwhich the most points defined by intersections between planesperpendicular to the axis and the channel surface 972 are equidistantfrom the axis (e.g., the channel axis 976 is centrally oriented for themost or all cross-sections of the channel surface 972 that areperpendicular to the channel axis 976).

In some embodiments, orienting the channels 960 to be parallel to theengagement axis 908 allows the glenosphere 900 to secure a greatersurface area or disparate surface areas of the shoulder bone (though theglenosphere 900 may have a less secure attachment to a specific surfacearea of the shoulder bone as compared to the glenosphere 100).

In some embodiments, a glenosphere includes a spherical body. Thespherical body can include a first edge that defines a complete pathabout the body. A first surface can extend from a first side of thefirst edge, and a second surface can extend from a second side of thefirst edge opposite the first side. For example, the first surface canbe adjacent to the second surface along the first edge, and together thefirst surface and the second surface can define a complete outer surfaceof the spherical body. The spherical body can define a center such thateach point on the first surface is equidistant from the center (or suchthat the greatest possible number of points on the first surface areequidistant from the center). The first edge can define (or include) afirst point and a second point. A first shortest path between the firstpoint and the second point along the first surface (e.g., such that theonly points on the first shortest path that coincide with the first edgeare the first point and the second point) is greater than half of acircumference of a spherical region defined by all points equidistantfrom the center. In some embodiments, such a glenosphere can thusinclude a hooded portion (e.g., the second point is located on thehooded portion), or has a greater-than-hemispherical form factor.

C. Glenosphere with Flange for Augmented Fixation and Related Methods

Referring now to FIGS. 23A-27B, various embodiments of glenospheresincluding a flange-type component for augmented fixation areillustrated. The glenospheres described with reference to FIGS. 23-27Bcan be similar to the glenospheres described with reference to FIGS.1-22 , and can be configured to engage or otherwise interact withvarious baseplates. In some embodiments, a glenosphere having a flangecomponent is kinematically advantageous for a patient having a shoulderprosthesis, as the flange enables the glenosphere to contact and besupported against a greater surface area of the shoulder bonesurrounding a fixation site at which fixation elements of theglenosphere and/or baseplate are secured, helping to stabilize theglenosphere against rocking or other disadvantageous movements. In someembodiments, a glenosphere having a surface for receiving the baseplatethat is offset relative to the center of the glenosphere canadvantageously bring the flange closer to the shoulder bone and/or awayfrom a fixation site at which the baseplate is fixated to the shoulderbone, further improving stability. In some embodiments, the flange canfacilitate distribution of forces between the shoulder prosthesis andthe baseplate that could otherwise damage the baseplate. The flange canbe configured to be positioned in or contact a superior aspect of theglenoid cavity. Unlike existing systems in which portions of aglenosphere may extend beyond a hemispherical shape or arrangement, butwhich cannot improve operation in bone loss applications, a glenospherehaving a flange according to various embodiments of the presentdisclosure can advantageously improve operation of a shoulder prosthesisin applications with bone loss (e.g., bone loss model applications).

Referring now to FIGS. 23A-23C, a glenosphere 1100 is shown. Theglenosphere 1100 can be similar in structure and function to variousglenospheres described herein. The glenosphere 1100 includes a body 1104and a flange 1150. The body 1104 includes a first body surface 1108 anda second body surface 1112. The second body surface 1112 can bespherical (e.g., define a surface for which many, most, or all pointsare equidistant from a reference point, such as a center of the body1104). The body 1104 includes an engagement feature 1120 configured toengage with an attachment structure (e.g., a plate or baseplate)attachable to the shoulder bone.

In some embodiments, the body 1104 has or defines a center 1116. Thecenter 1116 can be a point that equidistant from many, most, or allpoints on an exterior of the body 1104, and/or equidistant from many,most, or all points of the second body surface 1112. In someembodiments, the center 1116 can be a center of rotation for a humeralcomponent (not shown) coupled to the body 1104 and configured toarticulate about the second body surface 1112.

The engagement feature 1120 can be a cavity similar to variousembodiments of cavities as described herein. As shown in FIGS. 23A-23C,the engagement feature 1120 includes a first cavity portion 1124configured to receive an attachment structure (e.g., a plate), and asecond cavity portion 1132 configured to engage the attachmentstructure. The first cavity portion 1124 can include a cavity surface1126 (e.g., an engagement surface) against which the attachmentstructure can be positioned or received. In some implementations, thecavity surface 1126 may be separated from the first body surface 1108 bya wall defining a depth of the cavity.

The body 1104 can define an engagement axis 1118. The engagement axis1118 can be an axis passing through the engagement feature 1120 andindicating a direction against which the glenosphere 1100 generally isbrought towards the shoulder bone. In some embodiments, the engagementaxis 1118 is perpendicular or substantially perpendicular to the cavitysurface 1126. The engagement axis 1118 may align with a plate fixationmember of the plate when the plate is received in the first cavityportion 1124. In some embodiments, such as shown in FIG. 23C, theengagement axis 1118 passes through (e.g., includes, is collinear with)the center 1116.

In some embodiments, the engagement feature 1120 and/or the cavitysurface 1126 is offset by an engagement offset 1127 from the center 1116of the body 1104 (or from a plane 1128 including the center 1116 andparallel to the cavity surface 1126 or to an outer edge of the cavitysurface 1126). This offset can increase the range of motion forarticulation enabled by the second body surface 1112, as the second bodysurface 1112 may occupy a space greater than a hemispherical spacedefined as being equidistant from the center 1116, and can bring theflange 1150 closer to the shoulder bone when the plate is received andsecured by the engagement feature 1120 and the glenosphere 1100 isfixated to the shoulder bone. In some embodiments, the engagement offset1127 is approximately 6 mm (e.g., greater than or equal to 4 mm and lessthan or equal to 8 mm; greater than or equal to 5 mm and less than orequal to 9 mm). In some embodiments, the engagement offset 1127 isapproximately 10 mm (e.g., greater than or equal to 8 mm and less thanor equal to 12 mm; greater than or equal to 9 mm and less than or equalto 11 mm).

The flange 1150 extends radially outward from the body 1104 and includesa first flange surface 1154 contiguous with the first body surface 1108and a second flange surface 1156 contiguous with the second body surface1112. The flange 1150 can extend further radially outward from the body1104 than the second body surface 1112 (e.g., at least a portion of theflange 1150 is at a greater distance from the center 1116 than any pointon the second body surface 1112). In some embodiments, the flange 1150has a flange length (e.g., a length defined along an outer rim 1151 ofthe flange 1150) extending from a first end 1158 and a second end 1162such that an angle γ defined by a first line 1159 from the center 1116to the first end 1158 and a second line 1163 from the center 1116 to thesecond end 1162 is less than 180 degrees (e.g., less than 150 degrees,less than 120 degrees, less than 90 degrees, less than 180 degrees andgreater than 45 degrees). The body 1104 can include a glenosphere bodysurface 1110 that includes the first body surface 1108 and the firstflange surface 1154. The flange 1150 can provide additional support forthe glenosphere 1100 by adding surface area for stabilizing theglenosphere 1100 against the shoulder bone. The angle γ, or othermeasures of a size of the flange 1150 can be selected to reduce orminimize a total size or volume occupied by the glenosphere 1100. Forexample, in some configurations, as the size of the flange 1150increases, it may become more difficult to place the glenosphere 1100 inthe glenohumeral joint; if a too large flange 1150 is used, it mayinterference with range of motion of the humerus as well as interferewith soft tissue such as the subscapularis, supraspinatus, and/orinfraspinatus tissue. At the same time, increasing or maximizing asurface area of the flange 1150 that can contact the shoulder bone canincrease stability of the glenosphere 1100 or otherwise improve thekinematics of the glenosphere 1100.

In some embodiments, the flange 1150 includes a hole 1164 extending froma first hole opening 1166 defined by the first flange surface 1154 to asecond hole opening 1168 defined by the second flange surface 1156. Thehole 1164 can be configured to receive a glenosphere fixation member1101 (e.g., a fixation member similar or identical to glenospherefixation member 140) configured to attach the glenosphere to theshoulder bone. As shown in FIGS. 23A-23C, the glenosphere 1100 includesthree holes 1164. In various embodiments, various numbers of holes 1164can be included by the flange 1150 (e.g., 1, 2, 3, 4, 5, holes). Inother embodiments (e.g., as shown in FIG. 24 , the flange 1150 does notinclude a hole, e.g. has a continuous or uninterrupted surface).

In some embodiments, the second body surface 1112 defines a hole path1168. The hole path 1168 can be recessed within the second body surface1112. The hole path can be recessed towards the center 1116 (e.g., isrecessed into the body 1104 from the second body surface 1112; a surfaceof the hole path 1168 is closer to the center 1116 than an adjacentportion of the second body surface 1112). The hole path 1168 is incommunication with the second hole opening 1168 (e.g., is contiguouswith, transitions to), and can guide the glenosphere fixation member1101 into the hole 1164. When the glenosphere fixation member 1101 isreceived in the hole path 1168 and through the hole 1164, a portion ofthe glenosphere fixation member will be positioned closer to the center1116 relative to the second body surface 1112.

The hole 1164 can be configured to receive a plurality of glenospherefixation members 1101, or, as shown in FIGS. 23A-23C, can receiveglenosphere fixation members 1101 at different positions and/ororientations. For example, the hole 1164 can be configured to receivethe glenosphere fixation member 1101 at a first angle corresponding to afirst channel 1165 of the hole or at a second angle corresponding to asecond channel 1166 of the hole. The first channel 1165 can define afirst channel axis 1173, and the second channel 1166 can define a secondchannel axis 1175 (e.g., the channel axes can be defined as beingequidistant from many, most, or all points on the correspondingsurfaces). The channels 1165, 1166 can be contiguous with each other.The hole path 1168 can include portions aligned with each channel axis1173, 1175.

The channels 1165, 1166 can be configured to receive and/or secure theglenosphere fixation member. For example, the channels 1165, 1166 caninclude thread receiving surfaces configured to engage threads of theglenosphere fixation member 1101. The first channel axis 1173 can definea channel offset 1176 from the second channel axis 1175, such that aposition of the glenosphere fixation member 1101 when received in thefirst channel 1165 is offset from when received in the second channel1166. In some embodiments, the channel offset 1176 is approximately 3 mm(e.g., greater than or equal to 1 mm and less than or equal to 10 mm,greater than or equal to 1 mm and less than or equal to 5 mm, greaterthan or equal to 2 mm and less than or equal to 4 mm, 3 mm). In someembodiments, the first channel axis 1173 is parallel to the cavitysurface 1126 or the engagement axis 1118, and the second channel axis1175 is angled towards the cavity surface 1126 or the engagement axis1118 relative to the first channel axis 1173 (e.g., angled by 10degrees, by an angle greater than or equal to 5 degrees and less than orequal to 20 degrees; greater than or equal to 7.5 degrees and less thanor equal to 15 degrees; greater than or equal to 9 degrees and less thanor equal to 11 degrees). The angle between the first channel axis 1173and the second channel axis 1175 can provide more options for orientingand implanting the glenosphere 1100 in patients having varied sizesand/or glenoid bone loss in the glenoid cavity. As the angle increases,there may be more options for where the glenosphere fixation member canbe fixed to the shoulder bone. For example, the angle can enable theglenosphere fixation member to be fixed to a bone location (e.g., a bonelocation that increases or optimizes stability) at the base of thecoracoid or the acromion.

The hole 1164 can define a hole center 1178 that is equidistant from thechannel axes 1173, 1175, and falls within (e.g., is included within) aplane that includes the channels 1165, 1166. In embodiments where theflange 1150 includes more than one hole 1164, the channel centers 1178can be oriented at an angle δ defined from the center 1116 (e.g., anangle defined by lines from the center 1116 to the channel centers 1178or the channel axes 1173, 1175). The angle δ can indicate or be ameasure of an arcuate range of space (or a portion thereof) covered bythe flange 1150. The angle δ can be approximately 35 degrees (e.g.,greater than or equal to 20 degrees and less than or equal to 50degrees; greater than or equal to 30 degrees and less than or equal to40 degrees; greater than or equal to 34 degrees and less than or equalto 36 degrees).

Referring now to FIGS. 25A-25B, the glenosphere 1100 is shown having anoffset flange 1150. In some embodiments, the flange 1150 is configuredto be offset from the first body surface 1108. The flange 1150 can beoffset such that the flange 1150 is closer to the shoulder bone than thefirst body surface 1108 when the glenosphere 1100 is secured to theshoulder bone, and/or extends out and over the plate when the plate isreceived and engagement by the engagement feature 1120. In embodimentswhere the flange 1150 is offset, the glenosphere 1100 can thus beadapted to various geometries of the shoulder bone, such as for drawingthe flange 1150 closer to a portion of the shoulder bone that is awayfrom where the plate is fixated to the shoulder bone. In someembodiments, the offset of the flange 1150 can beneficially position thechannels 1165, 1166 further away from the center 1116 of the glenosphere1100 (as compared to a glenosphere that does include the flange 1150),and thus a range of motion of a humeral component articulating about thesecond body surface 1112. Such positioning can reduce the likelihood ofosteolysis that might result from friction between the humeral componentand the glenosphere 1100 that would generate wear particles that can bepushed through the channels 1165, 1166 into the shoulder joint by thearticulating humeral component.

The flange 1150 can be offset from the plane 1128 by a first offsetdistance 1180 (e.g., as measured to the first flange surface 1154), thefirst offset distance 1180 being greater than a second offset distance1182 by which the first body surface 1108 is offset from the plane. Insome embodiments, a difference between the first offset distance 1180and the second offset distance 1182 is approximately 3 mm (e.g., greaterthan or equal to 2 mm and less than or equal to 4 mm), 5 mm (e.g.,greater than or equal to 4 mm and less than or equal to 6 mm), or 7 mm(e.g., greater than or equal to 6 mm and less than or equal to 8 mm).The offsets may also be defined relative to a cavity surface 1126, or aplane passing through an outer edge of the cavity surface 1126.

Referring now to FIGS. 26A-26B, a glenosphere 1200 is shown. Theglenosphere 1200 can be similar to the glenosphere 1100, with theexception of the shape and/or orientation of the glenosphere bodysurface (e.g., the first flange surface and/or first body surface). Theglenosphere 1200 can include a body 1204, a first body surface 1208, anda second body surface 1212. The glenosphere 1200 can define a center1216 and an engagement axis 1218. The glenosphere 1200 can include aflange 1250 extending radially outward from the body 1204. The flange1250 can include a first flange surface 1254 and a second flange surface1256. The glenosphere 1200 can include a glenosphere body surface 1210including the first body surface 1208 and the first flange surface 1254.The glenosphere 1200 can define a plane 1228 that includes or passesthrough the center 1216.

In some embodiments, the first flange surface 1254 and/or theglenosphere body surface 1204 is oriented at an angle to the plane 1228.For example, a first end 1291 of the first flange surface 1254 (e.g., anend of the first flange surface 1254 that is further from the center1216, the engagement axis 1218, and/or adjacent to an exterior rim ofthe flange 1250) can be offset by a flange offset 1290 from the plane1228, while a second end 1209 of the first body surface 1208 (e.g., anend or point where the first body surface 1208 meets the second bodysurface 1212 and furthest from the flange 1250, the engagement axis1218, and/or the center 1216) is offset by a body offset 1292 from theplane 1228, the body offset 1292 being less than the flange offset 1290.The glenosphere body surface 1210 can be planar or substantially planar.A line 1293 between the first end 1291 and the second end 1292 candefine an angle ε relative to the body offset 1292, or may similarlydefine an angle at an intersection (not shown) of the line 1293 and theplane 1228, such that the glenosphere body surface 1204 is angledrelative to the plane 1228. The glenosphere body surface 1204 can beangled such that the body offset 1292 is approximately 3 mm (e.g.,greater than or equal to 2 mm and less than or equal to 4 mm), 5 mm(e.g., greater than or equal to 4 mm and less than or equal to 6 mm), or7 mm (e.g., greater than or equal to 6 mm and less than or equal to 8mm). The body offset can also be measured from the center 1216 to aplane 1295 including or passing through the first point 1219 andparallel to the plane 1228.

Referring now to FIGS. 27A-27B, a glenosphere 1300 is shown. Theglenosphere 1300 can be similar to the glenosphere 1200, with theexception of the shape of the first flange surface and/or glenospherebody surface as described herein. The glenosphere 1300 can include abody 1304, a first body surface 1308, and a second body surface 1312.The glenosphere 1300 can define a center 1316, an engagement axis 1318passing through the center 1316, and a plane 1328 including the center1316. A flange 1350 can extend radially outward from the body 1304 andinclude a first flange surface 1354 and a second flange surface 1356. Aglenosphere body surface 1310 can include the first body surface 1308and the first flange surface 1354. The glenosphere can include anengagement feature including a cavity surface 1326.

In some embodiments, the glenosphere 1300 has a curved or non-linear (ornon-planar) glenosphere body surface 1310 and/or a curved or non-linear(or non-planar) first flange surface 1310. A first flange offset 1393,defined from the plane 1328 to a first flange end 1392 (e.g., a point atwhich the first body surface 1308 is adjacent to the first flangesurface 1354), can be greater than a second flange offset 1391, definedfrom the plane 1328 to an outer flange end 1390 (e.g., an outermostpoint on the first flange surface 1354). The first flange offset 1393can also be greater than a first body offset 1394 a defined between theplane 1328 and a first body end 1309 a (e.g., an outermost point of thebody 1304 where the first body surface 1308 meets the second bodysurface 1312 and which may be furthest from the flange 1354), and may begreater than a second body offset 13094 defined between the plane 1328and a second body end 1309 b (e.g., a point at which a rim 1327 of anengagement feature 1324 intersects the first body surface 1308 andfurthest from the flange 1350). The offsets may also be defined relativeto a cavity surface 1326, or a plane passing through an outer edge ofthe cavity surface 1326. In some embodiments, the first flange end 1392is positioned closest to the shoulder bone when the glenosphere 1300 isfixated to the shoulder bone and/or to a plate, allowing glenospherefixation members received through the glenosphere to be closely securedto the shoulder bone while a significant portion of the body 1304 ispositioned away from the shoulder bone.

D. Glenosphere with Inserts for Augmented Fixation and Related Methods

Referring now to FIGS. 28A-35B, various embodiments of glenospheresystems implementing inserts (e.g., insert components) are illustrated.In various embodiments, the use of an insert component can improve theefficacy of shoulder arthroplasty by stabilizing glenospheres againstshoulder bones, such as the scapula, allowing for improved range ofmotion of the humerus, maintaining an anatomic or other desired centerof rotation even when glenoid bone loss or other bone loss has occurred,and/or enabling the glenosphere to be secured directly to the shoulderbone (additionally or alternatively to securing the glenosphere to theshoulder bone via a baseplate) to distribute the load between theglenosphere and the shoulder bone away from the baseplate to reduce therisk of baseplate failure. The insert component may be modular to allowfor a surgeon to have more flexibility in performing shoulderarthroplasty, such as to install new or replacement glenospheres onexisting baseplates (e.g., after removing an existing glenosphere,install a new glenosphere on a baseplate already secured to the shoulderbone).

In some embodiments, such as shown in FIGS. 28A-35B, a glenospheresystem 1400 includes an insert component 1410, a glenosphere 1460, and abaseplate 1480. The glenosphere 1460 can be similar to variousglenospheres described herein. The baseplate 1480 can be similar tovarious baseplates described herein. The baseplate 1480 may receiveplate fixation members 1482, which may be similar to various fixationmembers described herein. The baseplate 1480 may include or beassociated with a bone engagement member 1484, which may be similar tovarious bone engagement members described herein.

In some embodiments, the glenosphere 1460 includes a first surface 1464,a second surface 1468, a plate engagement region 1472, and an insertengagement region 1476. The plate engagement region 1472 is configuredto engage the baseplate 1480. For example, the plate engagement region1472 may include a cavity configured to receive the baseplate 1480. Theinsert engagement region 1476 is configured to engage the insertcomponent 1410. As shown in FIG. 28A, the insert engagement region 1476may include a cavity (e.g., recess) configured to receive the insertcomponent 1410. The insert engagement region 1476 may includeprotrusions configured to be received by the insert component 1410. Theinsert engagement region 1476 may be configured to couple to the insertcomponent 1410 using a Morse taper.

In some embodiments, the insert component 1410 (e.g., a body of theinsert component 1410) includes a first surface 1412, a second surface1416, and a third surface 1420. The first surface 1412 may extend from afirst end 1413 to a second end 1414. The first surface 1412 can beconfigured to engage a bone. For example, the first surface 1412 mayinclude bony growth surfaces (e.g., rough surfaces, etched surfaces)configured to facilitate bone growth. The second surface 1416 is spacedfrom the first surface 1412. The second surface 1416 can cooperate withthe first surface 1412 to define at least one channel 1428. The at leastone channel 1428 can be configured to receive an engagement member tosecure the insert component 1410 to a bone. In some embodiments, theinsert component 1410 includes a fourth surface 1424.

The third surface 1420 may include a first end 1430 and a second end1432. The first end 1430 and second end 1432 may be adjacent to thefirst surface 1412, such that the first end 1430 and second end 1432extend from a perimeter of the first surface 1412. The third surface1420 may include or define a curved portion 1434 between the first end1430 and second end 1432. The curved portion may be shaped to contact abone engagement member (e.g., bone engagement member 1484), such as toenable the insert component 1410 to be positioned against a portion ofthe baseplate 1484 adjacent to the bone engagement member 1484, whichmay help stabilize the glenosphere system 1400 and/or distribute loadfrom the baseplate 1480 to the insert component 1410. In someembodiments, the first surface 1412 defines a first arc length (e.g.,along an edge of the first surface 1412) from the first end 1413 to thesecond end 1414, and the third surface 1420 defines a second arc length(e.g., along an edge of the third surface 1420) from the first end 1430to the second end 1432. The first arc length may be greater than thesecond arc length, such as to increase a surface profile of the insertcomponent 1410 in a region where the insert component is configured tocontact (e.g., engage) a shoulder bone to stabilize the glenospheresystem 1400, while maintaining a low profile near where the insertcomponent 1410 may be adjacent to the baseplate 1480, which mayfacilitate assembly of the glenosphere system 1400 during surgicalprocedures with varying geometries of components of the glenospheresystem 1400.

In some embodiments, the insert component 1410 includes a cavity 1436.The cavity 1436 may include a first cavity opening 1438 defined by thefirst surface 1412. The cavity 1436 may include a second cavity opening1439 defined by the second surface 1424 (or a surface of the insertcomponent 1410 adjacent to the second surface 1424). The cavity 1436 maybe defined within the insert component 1410 (e.g., within a body of theinsert component 1410). The cavity 1436 may define a first cavity region1440 and a second cavity region 1442, which may each be coextensive witha third cavity region 1444. As shown in FIG. 28A, the curved portion1434 of the third surface 1420 may extend into the insert component 1410and thus define a portion of the third cavity region 1444.

In some embodiments, the first cavity region 1440 defines a first cavitydiameter 1446, the second cavity region 1442 defines a second cavitydiameter 1448, and the diameters 1446, 1448 are each greater than adiameter of a plate fixation member 1482, such that at least one of thefirst cavity region 1440 or the second cavity region 1442 may receivethe plate fixation member 1482. The cavity 1436 may be between the thirdsurface 1420 and the at least one channel 1428.

In some embodiments, the at least one first channel 1428 defines a firstchannel axis 1429. The cavity 1436 can define a cavity axis 1437. Thefirst channel axis 1429 may be parallel to the cavity axis 1437, whichmay help align the insert component 1410 with the baseplate 1480.

As shown in FIGS. 28A, 28C, and 28F, in some embodiments, the fourthsurface 1424 is configured to engage a first surface 1481 of thebaseplate 1480. For example, a first plane parallel to the fourthsurface (e.g., where the fourth surface 1424 defines the second opening1439) may be spaced from a second plane parallel to the second surface1416 (e.g., where the second surface 1416 defines an opening of the atleast one first channel 1428). For example, the first plane may becloser to the first surface 1412 than the second plane. In some suchembodiments, the insert component 1410 may thus be configured tostabilize the baseplate 1480 and glenosphere 1460 by securing thebaseplate 1480 to the glenosphere 1460 while securing the glenosphere1460 to the shoulder bone.

Referring now to FIGS. 29A-29D, in some embodiments, a glenospheresystem 1500 includes an insert component 1510, a glenosphere 1560, and abaseplate 1580. The glenosphere system 1500 can be similar to andinclude features of the glenosphere system 1400. As described herein,the glenosphere system 1500 can include an insert component 1510including at least one second channel 1550.

For example, as shown in FIGS. 29A-29D, the insert component 1510includes at least one first channel 1528, and also includes the at leastone second channel 1550. The at least one second channel 1550 may be onan opposite side of the at least one first channel 1528 from a cavity1536, such that the at least one second channel 1550 allows for theinsert component 1510 to be secured to portions of bone further from theportions secured by the baseplate 1580 than the at least one firstchannel 1528. The insert component 1510 may include a channel surface1518, extending above the portion of the insert component 1510 definingthe at least one first channel 1528, the channel surface 1518cooperating with the first surface 1512 to define the at least onesecond channel 1550. The at least one second channel 1550 is configuredto receive a bone fixation member (e.g., bone fixation member 1509)configured to secure the insert component 1510 to bone. The at least onesecond channel 1550 may have a diameter greater than a diameter of theat least one first channel 1528, such as to accommodate bone fixationmembers 1509 having a greater diameter than those for the at least onefirst channel 1528 (e.g., to improve fixation of the insert component1510 via the at least one second channel 1550).

In some embodiments, the at least one second channel 1550 defines atleast one second channel axis 1551. The at least one second channel 1550may be configured such that the second channel axis 1551 is not parallelto a first channel axis 1529 of the at least one first channel 1528.

In some embodiments, the portion of the insert component 1510 definingthe at least one second channel 1550 is configured to extend above theglenosphere 1560 when the insert component 1510 is engaged to theglenosphere 1560. For example, a first distance from a first rim 1545where the first surface 1512 is adjacent to the third surface 1520 to asecond rim 1546 of the first surface 1512 opposite the first rim 1545and adjacent to the at least one second channel 1550 can be greater thana second distance from a point of an insert engagement region of theglenosphere 1560 (e.g., an insert engagement region similar to insertengagement region 1476 of glenosphere 1460) to a glenosphere rim where afirst surface 1564 is adjacent to a second surface 1568.

Referring now to FIGS. 30A-30D, in some embodiments, a glenospheresystem 1600 includes at least one of an insert component 1610 or aflange component 1650. The glenosphere system also includes aglenosphere 1660 and a baseplate 1680. The glenosphere system 1600 maybe similar to the glenosphere systems 1400, 1500 described herein. Theinsert component 1610 may be similar to the insert components 1410,1510. The glenosphere 1660 may be similar to the glenospheres 1460,1560. The baseplate 1680 may be similar to the baseplates 1480, 1580. Insome embodiments, the flange component 1650 can include features of andperform similar functions as the flange components described withrespect to FIGS. 23A-27B.

As shown in FIGS. 30A-30D, the glenosphere system 1600 may include oneor both of the insert component 1610 and the flange component 1650. Forexample, the flange component 1650 may enable additional securing of theglenosphere 1660 to shoulder bones (e.g., to portions of shoulder bonesnot secured by the insert component 1610). As shown in FIG. 30D, in someembodiments, the glenosphere 1550 includes an insert engagement region1662 configured to engage the insert component 1610, and may similarlyinclude a flange engagement region 1664 configured to engage the flangecomponent 1650. The insert engagement region 1662 may be radially spacedfrom the flange engagement region 1664, such as to allow the insertcomponent 1610 and flange component 1650 to couple to differing portionsof bones. In some embodiments, the flange component 1650 includes atleast one first channel 1652 configured to receive at least one firstbone fixation member 1654, and at least one second channel 1656configured to receive at least one second bone fixation member 1658(which may have a greater diameter than the at least one first bonefixation member 1654). The at least one second channel 1656 may beoriented at an angle relative to the at least one first channel 1652.The glenosphere system 1600 may be configured such that the at least onefirst channel 1652 is parallel to at least one first channel 1628 of theinsert component 1610 (e.g., based on the configuration of theengagement regions 1662, 1664 and the channels 1628, 1652).

Referring now to FIGS. 31A-31C, in some embodiments, a glenospheresystem 1700 includes an insert component 1710, a glenosphere 1760, and abaseplate 1780. The glenosphere system 1700 can be similar to theglenosphere systems 1400, 1500, and 1600. The insert component 1710includes an angled first surface 1720. For example, the insert component1710 may be configured such that an angle α, defined between a channelaxis 1722 of at least one channel 1721 and a cavity axis 1724 (of cavity1724) which is in a same plane as and intersects the channel axis 1722,is perpendicular or nearly perpendicular (e.g., less than 120 degrees,less than 105 degrees, less than 90 degrees, less than 75 degrees,greater than 45 degrees and less than 120 degrees, or variouscombinations thereof).

Referring now to FIG. 32 , in some embodiments, a glenosphere system1800 includes an insert component 1810, a glenosphere 1860, and abaseplate 1880. The glenosphere system 1800 can be similar to thevarious glenosphere systems described herein (e.g., glenosphere systems1400, 1500, 1600, 1700), with the exception of the configuration of theinsert component 1810. As shown in FIG. 32 , the insert component 1810includes a first surface 1812, second surface 1816, and third surface1820. The second surface 1816 is spaced from and parallel to the firstsurface 1812. The third surface 1820 extends from the first surface 1812and second surface 1820, and can be shaped to receive a rim surface 1881of the baseplate 1880. In some embodiments, the first surface 1812 andsecond surface 1816 form continuous surfaces (e.g., devoid of openings,such as openings for channels or cavities as described with respect toinsert component 1410).

Referring now to FIG. 33 , in some embodiments, a glenosphere system1900 includes an insert component 1910, a glenosphere 1960, and abaseplate 1980. The glenosphere system 1900 can be similar to thevarious glenosphere systems described herein (e.g., glenosphere systems1400, 1500, 1600, 1700, 1800), with the exception of the configurationof the insert component 1910. As shown in FIG. 33 , the insert component1910 can be similar to the insert component 1810, and can include atleast one channel 1928 configured to receive at least one bone fixationmember 1902.

Referring now to FIG. 34 , in some embodiments, a glenosphere system2000 includes an insert component 2010, a glenosphere 2060, and abaseplate 2080. The glenosphere system 2000 can be similar to thevarious glenosphere systems described herein (e.g., glenosphere systems1400, 1500, 1600, 1700, 1800, 1900), with the exception of theconfiguration of the insert component 2010. As shown in FIG. 34 , theinsert component 2010 can be similar to the insert component 1910, andcan include a first surface 2012 that is spaced from and at an anglerelative to second surface 2016 (e.g., a plane parallel to the firstsurface 2012 may intersect a plane parallel to the second surface 2016at an acute angle), which can facilitate securing the glenosphere system2000 to corresponding shoulder bone geometries.

Referring now to FIGS. 35A-35B, in some embodiments, a glenospheresystem 2100 includes a plurality of insert components 2110, aglenosphere 2160, and a baseplate 2180. The glenosphere system 2100 canbe similar to the various glenosphere systems described herein (e.g.,glenosphere systems 1400, 1500, 1600, 1700, 1800, 1900, 2000), and isconfigured to provide the plurality of insert components. As shown inFIGS. 35A-35B, the glenosphere 2160 includes a first surface 2164, asecond surface 2168, and a plurality of insert engagement regions 2176which may be spaced radially outward from and surrounding a plateengagement region 2172. The plurality of insert engagement regions 2176can be configured to engage corresponding insert components 2110. Asshown in FIG. 35A, the insert components 2110 may include channels forreceiving bone fixation members (e.g., similar to insert component1910), while as shown in FIG. 35B, the insert components may includecontinuous surfaces (e.g., void of channels), similar to insertcomponent 1810.

What is claimed is:
 1. An insert component for use with a glenosphere,comprising: an insert body including a first surface, a second surface,and a third surface; the first surface configured to engage a bone,wherein a face of the first surface is flat; the second surface spacedfrom the first surface and cooperating with the first surface to defineat least one first channel passing linearly from the second surfacethrough the insert body to the first surface, the at least one firstchannel configured to receive an engagement member passing from secondsurface through the insert body to the first surface; the third surfacelocated between the first surface and the second surface, a curvedportion of the third surface extending into the insert body, the curvedportion shaped to contact a bone engagement member; a cavity definedwithin the insert body, the cavity including a first cavity openingdefined by the first surface and a second cavity opening defined by thesecond surface, the cavity defining a first cavity region and a secondcavity region each coextensive with a third cavity region, the firstcavity region and second cavity region each having a cavity diametergreater than a diameter of a plate engagement member and configured toallow the plate engagement member to pass through the insert body viathe cavity from the second surface to the first surface; and a fourthsurface extending from the third surface, the fourth surface definingthe second cavity opening of the cavity opposite the first cavityopening.
 2. The insert component of claim 1, wherein at least one firstchannel defines a first channel axis parallel to a cavity axis definedby the cavity.
 3. The insert component of claim 1, wherein the firstsurface is configured to promote bone growth.
 4. The insert component ofclaim 1, wherein the cavity is between the third surface and the atleast one channel.
 5. The insert component of claim 1, wherein a firstarc length along a first rim of the first surface is greater than asecond arc length of the curved portion of the third surface.
 6. Theinsert component of claim 1, further comprising at least one secondchannel on an opposite side of the at least one first channel from thecavity, the at least one second channel configured to receive a bonefixation member configured to secure the insert component to the bone.7. The insert component of claim 6, wherein a first plane parallel to afirst opening of the at least one first channel defined by the secondsurface is spaced from a second plane parallel to a second opening ofthe at least one second channel.
 8. The insert component of claim 6,wherein the at least one second channel defines a second channel axisthat is not parallel to a first channel axis defined by the at least onefirst channel.